CRCR Practice Questions Graded + 2023
The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities?
A. Complete a community needs assessment and develop a discount program for patient balances after
insurance payment.
B. Pursue extraordinary collection activities with all patients eligible for financial assistance.
C. Implement a financial assistance program for uninsured and underinsured patients.
D. Discount all charges to self-pay patients to an amount generally billed to all other patients. Ans- A.
Complete a community needs assessment and develop a discount program for patient balances after
insurance payment
The accurate capture of charges remains critically important because:
A. Of the potential of fraud and abuse charges from erroneous billing.
B. Charges remain one of the few consistent indicators available to monitor resource use.
C. Charges are means of measuring physician productivity.
D. Charges provide the data used in activity based costing. Ans- B. Charges remain one of the few
consistent indicators available to monitor resource use
The ACO investment model will test the use of pre-paid shared savings to:
A. Invest in treatment protocols that reduce costs to Medicare
B. Attract physicians to participate in the ACO payment system.
C. Raise quality ratings in designated hospitals.
D. Encourage new ACOs to form in rural and underserved areas. Ans- D. Encourage new ACOs to form in
rural and underserved areas
Across all care settings, if a patient consents to a financial discussion during a medical encounter to
expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all of the required
registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining required patient
financial data.
,C. Support that choice, providing that the discussion does not interfere with patient care or disrupt
patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient flow. Ans- C. Support
that choice, providing that the discussion does not interfere with patient care or disrupt patient flow
Activities completed when the scheduled, pre-registered patient arrives for service includes:
A. Verifying insurance, activating the record and directing the patient to the service area.
B. Scanning the driver's license or other phot identification and directing the patient to the financial
counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. Ans- C. Activating the record,
obtaining signatures and
The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as:
A. Utilization review
B. Case Management
C. Census Management
D. Patient through-put Ans- A. Utilization review
or
B. Case Management
An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the registration process. Ans- C. The
opportunity to reduce processing times at the time of service.
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can:
,A. Obtain price estimates for medical services
B. Negotiate the price of medical services with providers
C. Purchase qualified health benefit plans regardless of insured's health status
D. Meet federal mandates for insurance coverage and obtain the corresponding tax deduction Ans- C.
Purchase qualified health benefit plans regardless of insured's health status.
All of the following are conditions that disqualify a procedure or service from being paid for by Medicare
EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature Ans- C. Not delivered in a Medicare licensed care
setting
All of the following are reference resources used to help guide in the application for business ethics
EXCEPT:
A. Consumer satisfaction reports
B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies Ans- A. Consumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts Ans- A. Placing collections in a lock-box for posting review the next business day
All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
, C. Identifying and documenting the patient's health plan benefits
D. Confirming the patient's eligibility for benefits Ans- B. The patient signing the statement of financial
responsibility
All of the following information is used to identify a patient EXCEPT:
A. Date of Birth
B. Gender
C. Social Security Number
D. Address Ans- D. Address
All of the following information should be reviewed as part of schedule finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions Ans- A. The estimated patient financial obligations
Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
C. Services provided before a patient is admitted and for ambulance rides arranged to pick up the
patient from the hospital after discharge to take him/her home or to another facility
D. The portion of the bill outside of the patient's self-pay Ans- C. Services provided before a patient is
admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to
take him/her home or the another facility
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
treatment services for an enrolled group of persons on a monthly fee is known as a:
A. HMO
B. PPO
C. MSO
The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities?
A. Complete a community needs assessment and develop a discount program for patient balances after
insurance payment.
B. Pursue extraordinary collection activities with all patients eligible for financial assistance.
C. Implement a financial assistance program for uninsured and underinsured patients.
D. Discount all charges to self-pay patients to an amount generally billed to all other patients. Ans- A.
Complete a community needs assessment and develop a discount program for patient balances after
insurance payment
The accurate capture of charges remains critically important because:
A. Of the potential of fraud and abuse charges from erroneous billing.
B. Charges remain one of the few consistent indicators available to monitor resource use.
C. Charges are means of measuring physician productivity.
D. Charges provide the data used in activity based costing. Ans- B. Charges remain one of the few
consistent indicators available to monitor resource use
The ACO investment model will test the use of pre-paid shared savings to:
A. Invest in treatment protocols that reduce costs to Medicare
B. Attract physicians to participate in the ACO payment system.
C. Raise quality ratings in designated hospitals.
D. Encourage new ACOs to form in rural and underserved areas. Ans- D. Encourage new ACOs to form in
rural and underserved areas
Across all care settings, if a patient consents to a financial discussion during a medical encounter to
expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all of the required
registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining required patient
financial data.
,C. Support that choice, providing that the discussion does not interfere with patient care or disrupt
patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient flow. Ans- C. Support
that choice, providing that the discussion does not interfere with patient care or disrupt patient flow
Activities completed when the scheduled, pre-registered patient arrives for service includes:
A. Verifying insurance, activating the record and directing the patient to the service area.
B. Scanning the driver's license or other phot identification and directing the patient to the financial
counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. Ans- C. Activating the record,
obtaining signatures and
The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as:
A. Utilization review
B. Case Management
C. Census Management
D. Patient through-put Ans- A. Utilization review
or
B. Case Management
An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the registration process. Ans- C. The
opportunity to reduce processing times at the time of service.
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can:
,A. Obtain price estimates for medical services
B. Negotiate the price of medical services with providers
C. Purchase qualified health benefit plans regardless of insured's health status
D. Meet federal mandates for insurance coverage and obtain the corresponding tax deduction Ans- C.
Purchase qualified health benefit plans regardless of insured's health status.
All of the following are conditions that disqualify a procedure or service from being paid for by Medicare
EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature Ans- C. Not delivered in a Medicare licensed care
setting
All of the following are reference resources used to help guide in the application for business ethics
EXCEPT:
A. Consumer satisfaction reports
B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies Ans- A. Consumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts Ans- A. Placing collections in a lock-box for posting review the next business day
All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
, C. Identifying and documenting the patient's health plan benefits
D. Confirming the patient's eligibility for benefits Ans- B. The patient signing the statement of financial
responsibility
All of the following information is used to identify a patient EXCEPT:
A. Date of Birth
B. Gender
C. Social Security Number
D. Address Ans- D. Address
All of the following information should be reviewed as part of schedule finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions Ans- A. The estimated patient financial obligations
Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
C. Services provided before a patient is admitted and for ambulance rides arranged to pick up the
patient from the hospital after discharge to take him/her home or to another facility
D. The portion of the bill outside of the patient's self-pay Ans- C. Services provided before a patient is
admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to
take him/her home or the another facility
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
treatment services for an enrolled group of persons on a monthly fee is known as a:
A. HMO
B. PPO
C. MSO
